The Supreme Court ruled on June 25 that the Trump administration can end Temporary Protected Status for roughly 330,000 Haitians and 6,000 Syrians. The work authorizations for Haitians expire on July 10. Deportations can begin immediately after.
The ruling was a win for the administration’s immigration policy. It also creates a problem that lawmakers from both parties say the country is not prepared for.
“Of the 350,000-plus lawful Haitian TPS holders, roughly one-third work in our healthcare system,” wrote Representative Mike Lawler, a New York Republican, on X. “Immediately shutting off TPS will create a crisis in our hospitals, nursing homes, and in the intellectual disabilities community.”
The numbers behind the warning
About 13,000 Haitian TPS holders work daily as nursing assistants, caring for 65,000 patients, according to an investigation by The Boston Globe. Another 8,000 Haitian caregivers serve 12,000 children and elderly people, according to Americans for Immigrant Justice.
The impact is concentrated in three states: Florida, New York, and Massachusetts. Florida has the largest TPS population in the country, nearly 404,000 people, and the highest proportion of elderly residents. About 158,000 Haitians with TPS live in Florida, mainly in the southern part of the state.
Nursing homes and assisted living facilities in South Florida are already feeling the pressure. Rachel Blumberg, CEO of the Toby and Leon Cooperman Sinai Residences in Boca Raton, told Newsday she lost 10 workers whose permission to stay came under humanitarian parole programs and expects to lose 30 more with the end of Haitian TPS.
Blumberg got less than 24 hours’ notice when employees lost their work authorization. She has boosted salaries and referral bonuses, but says replacing aides, maintenance workers, and dishwashers will be difficult.
“Unfortunately, Americans are not drawn to applying and working in the positions that we have available,” she said.
A workforce gap the system cannot fill
The US is facing a demographic reality that immigration policy cannot wish away. The Baby Boom generation is aging into the years when care needs rise. The Bureau of Labor Statistics projects more growth among home health and personal care aides than any other job category, some 820,000 new positions by 2032.
The existing workforce is already stretched. More than a quarter of the estimated 4 million nursing assistants, home health aides, personal care aides, and other direct care workers are foreign-born, according to PHI, a nonprofit that tracks the caregiving workforce. These workers earn an average of $16.72 an hour.
The end of TPS removes a significant portion of that workforce at the worst possible time, just as demand is accelerating and long-term care homes are still recovering from pandemic-era worker exodus.
Representative Ayanna Pressley, a Massachusetts Democrat, put it bluntly: “Seniors will lose their caregivers when we already have a caregiving crisis.”
Beyond TPS
The problem extends beyond the Haitians and Syrians whose TPS protections have ended. The administration has also ended TPS for Afghans and Cameroonians. Designations for Ethiopians are blocked by court order but not resolved. TPS for Salvadorans ends in September 2026.
And the TPS issue is only part of a larger immigration crackdown that is affecting healthcare hiring across the board. Nursing homes that recruit registered nurses and licensed practical nurses from abroad are finding visa approvals taking far longer than before. Mark Sanchez, chief operating officer of United Hebrew, a nursing home in New Rochelle, New York, described the process as “lines upon lines upon lines.” Candidates are choosing Canada and Germany instead.
“The Trump administration may remove the temporary protected status of Haitians and Syrians, and with it, the caregivers that hundreds of thousands of elderly and disabled Americans depend on,” the Guardian reported.
A policy with consequences
The Supreme Court’s 6-3 ruling is the law of the land. The administration has the authority it sought to end TPS for Haiti and Syria. But the effect is the same whether the policy is intentional or collateral: thousands of nurses, aides, and home care workers will lose their right to work in the United States at a moment when the country needs more of them, not fewer.
The aging US population is not going to stop aging because the immigration policy changed. The caregivers are leaving. The patients are staying.